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Date "�I��y <br />f u1�Lt Wed! P��mil � _ �_--f� � <br />t'av f�eol . ��� �� —� <br />Applicallon For I _ <br />PUBLIC WC�RKS PERMIT P�bl¢WarMtFea s.,A._�� <br />To1�1 �ee <br />��� <br />Le++�cn� fenFUE 8 —' <br />���0 (7 �.� <br />BeixnceDue S = <br />Print or Typt� Only �� � �-z- <br />98201 7i?-tl� --- <br />Doyden .Realty, Inc. 14=9 Broadwav Eve�;ytt Z,p phone <br />Ownet AleilinB Address <br />Boyden fiealty, Inc. <br />dbn J b D Uidlders 1429 Broadway E�•erett 9820i _ 252-1166 __ <br />— Maii�ngAddross City 2ip Phone <br />Applicant <br />DescNbe Proposed Work New Sin¢le..E.7m11Y Rp°i drnrn <br />^t/ QShh P7 Q F F��ara�-t _ <br />Prol��� Address �II known) � <br />Atlech lour (4) coples ol plans lor propoaed work � Drew lo scale anA note Ihe lollowiny as eppliceb�e <br />• PrapB�tY Lines <br />• Outline nnd dimeosbns ol ell existing and <br />yroposed f IrUctureS o� Ihe lot <br />• Existing ani proposad utllllles <br />• Conterlinn ol sVeet <br />• Inditate Norlh <br />• Show anyp�oposetl gratlin9 r.han�es <br />• Show measurements <br />LI <br />PERMIT COPIf71TIONS <br />1. All cells loi Inapection ahall ba made 24 hrs. In advance - PhonN 2b9•8B1 5. <br />2. All work ehall be peAormed In eccordanca wilh this permit and current Gl;v of Evorett �esign .nd Construr.lion <br />Standnrds ond Specilicaliona. <br />3. Cnll L ocetion Underp�ound Service 4A h�s. be�nre you d�9 TOLL FREE NUMCER 1'BP�i•424•555J. <br />FINAL INSNtuii�rv ( \ ' <br />ADProved ns Gonstructad _ J <br />iVe/P�� PIIBLIC WORKS DEPARTMENT <br />� 3200 CeP3r Street <br />Everett WA 98201 <br />Phone- 259�8815 <br />ACKNGWLEDGE•'v1ENT OF CONDITIONS <br />� <br />O <br />� <br />V / <br />O <br />a <br />1 he unders�gned ow.ier/eDP�`cnnt hereby agrxes to hold end savo haim� <br />less Ihe City ol Everetl Irort any �md all �•.laims lor demaBE,, cosls, <br />expensss, or causes of action �he1 mey arlse because ol inslallation <br />end mafntenence ol Ihe Improveme.d o� other righbof-way use he�eto <br />applied lor end iuriher agraes to rc�novo seme upon nolice from the <br />City nnd to replace public proparty demaped Ihereby. <br />...� � � `�' � �� —1—�--� <br />// ~� DH�A <br />Signalive ot Appllcent <br />BORD YSTOF� DATC� PERMIT ISE SSUFD AND THEREAPT�ER ISHTO <br />BE DILIGENTLY V'UHSUED TO COMFLETION. THIS PERM�T MAV BE <br />CANCEI_L[D BV TH[ CITV UPON 4NY STOPPAGE OF WORK ON THIS <br />PqOJECT OVC_R 00 DAVS DURATION <br />z <br />0 <br />-� <br />� <br />m <br />-� �- <br />� � <br />r• <br />0 <br />�� <br />fn c <br />� <br />� � <br />O '] <br />��, <br />–� :- <br />2 --1 <br />m <br />... <br />c>Z <br />f ~ <br />x <br />«r �-. <br />K N <br />T <br />O A <br />'�l Y <br />3 <br />-i m <br />m .- <br />N <br />om <br />cy v+ <br />fn N <br />2 (7 <br />.i m <br />a <br />T <br />